PROVIDER DIRECTORY - Cigna

[Pages:140]PROVIDER DIRECTORY

Cigna-HealthSpring STAR+PLUS

CIGNA-HEALTHSPRING STAR+PLUS DIRECTORIO DE PROVEEDORES

August 2019

Hidalgo Service Area: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, and Zapata Counties

Member Services Department: 1-877-653-0327 (TTY 7-1-1) Monday to Friday, 8 a.m. to 5 p.m. Central Time

Agosto 2019

Hidalgo ?rea de servicio: Condados de Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, y Zapata

Departamento de Servicios para Miembros: 1-877-653-0327 (TTY 7-1-1) De lunas a viernes, de 8 a.m. a 5 p.m. Hora del centro

MCDTX_19_77836 NA ? 2019 Cigna

HISPH7-0919

Table of Contents

Section 1

Introduction

ii

Primary Care Provider Information

ii

OB/GYN Provider Information

ii

Family Planning Information

iii

Behavioral Health Provider and Facilities Information

iii

Long-Term Services and Support Information

iii

Pharmacy Information

iii

Texas Health Steps Provider Information

iii

Ancillary Provider Information

iv

How to Find Providers in Your Area

iv

Section 2

Network Providers

iv

How to Choose a Primary Care Provider

iv

How to Choose a Specialty Care Provider

iv

How to Choose Other Plan Providers

iv

Description of Provider Specialties

v

Section 3

List of Providers Primary Care Providers (PCP)

1

Urgent Care and After Hour Providers

26

Specialty Care Providers

33

Hospital Providers

71

Behavioral Health Providers and Facilities

72

Long-Term Services and Supports Providers

79

Pharmacy Providers

96

Dental Providers

97

Vision Providers

98

Nursing Facility Providers

99

Ancillary Service Providers

100

Section 4

Provider Index

111

SECTION 1

INTRODUCTION WELCOME TO CIGNA-HEALTHSPRING! You will get most of your medical services through Cigna-HealthSpring. We work with many doctors and hospitals in your community. When you sign up with Cigna-HealthSpring, you have a participating Primary Care Provider (PCP) "main doctor" who will help you get the right care for all of your health and medical needs.

This Provider Directory provides a list of Cigna-HealthSpring's network providers. The "network providers" listed in this directory have agreed to provide you with your health care coverage. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. You may go to any Cigna-HealthSpring participating provider.

PRIMARY CARE PROVIDER INFORMATION When you enroll in Cigna-HealthSpring, you need to pick one of our network providers that are listed in this directory to be your Primary Care Provider or PCP. The term "PCP" will be used throughout this directory. Generally, you must get health care coverage from your PCP. Your PCP is a doctor or other healthcare provider who is trained to provide general medical care. A PCP can also help manage any other services you may need.

If you have both Medicare and Medicaid coverage, you have two kinds of medical coverage. Your STAR+PLUS benefits will not reduce or change any of your Medicare benefits. Your PCP will be the doctor you have chosen through your Medicare HMO. You do not have to choose another PCP for STAR+PLUS services. Make sure that your Service Coordinator knows the name of your Medicare PCP.

The following types of providers may be selected by any Cigna-HealthSpring Member as a PCP: Doctors specializing in Family Practice Doctors specializing in General Practice Doctors specializing in Internal Medicine Advanced Practice Registered Nurse (APRNS) - specializing in Adult and Family Practice Doctors specializing in Obstetrics/Gynecology (OB/GYN) ? Female Members only Certified Registered Nurse Practitioners specializing in Women's Health ? Female Members Only Rural Health Clinic (RHC) Federally Qualified Health Clinic (FQHC) Pediatricians -- Members who are under the age of 21 Advanced Practice Registered Nurse (APRN) - specializing in Pediatrics ? Members under the age of 21

Any Cigna-HealthSpring Member may select a Specialist doctor to act as their PCP. The Specialist doctor will need to agree to perform all of the duties of a PCP.

If you need help picking a PCP, please call our Member Services Department at 1-877-653-0327, Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711). OB/GYN PROVIDER INFORMATION You have the right to pick a Cigna-HealthSpring OB/GYN without a referral from your PCP. You have access to the following services of an OB/GYN:

One well-woman checkup per year Care related to pregnancy Care for any female medical condition Referral to a specialist doctor within the network You can also receive these services from your Primary Care Provider if you would like. Ask your PCP if he or she can give you OB/GYN care. You can call your Service Coordinator or Cigna-HealthSpring Member Services for help in picking an OB/GYN doctor.

To enroll in Cigna-HealthSpring Call 1-800-964-2777 ii

FAMILY PLANNING INFORMATION Family planning services such as birth control and counseling are very private; you do not need to ask your PCP to get these services. The Texas Women's Health Program offers you family planning services that fit the way you live. Visit , or call 1-800-335-8957 for help filling out the application or to find a doctor or clinic. You can also call Cigna-HealthSpring Member Services at 1-877-653-0327, Monday to Friday, 8 a.m. to 5 p.m. Central Time for assistance, TTY users (711). BEHAVORIAL HEALTH PROVIDER AND FACILITIES INFORMATION You can get behavioral health (mental health and substance abuse) services without a referral from your PCP. To get mental health and substance abuse services, call the Cigna-HealthSpring Behavioral Health Line at 1-877-725-2539. A representative will help you get the care you need by giving you the name of a provider near you. If you are experiencing a behavioral health emergency, you can call our Crisis Hotline at 877-562-4397 24 hours a day, 7 days a week.

LONG TERM SUPPORT SERVICES INFORMATION You can get long-term support services (LTSS) such as adult foster care, assisted living services, day activity and health services and more as a Cigna-HealthSpring Member. Please call your Service Coordinator at 1-877-725-2688 Monday to Friday, 8 a.m. to 5 p.m. Central Time. A Service Coordinator will complete a health risk assessment that will identify the services that you may need. If you are eligible for any of these services, you, your Cigna-HealthSpring Service Coordinator, and your PCP will work together to get these services in place.

PHARMACY INFORMATION You will receive your prescription medicine from participating Cigna-HealthSpring pharmacies. You do not have a limit on the number of medicines you get each month. To find out which pharmacies are in Cigna-HealthSpring's network, you can call us at 1-877-653-0327 Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711) or look on our website at

TEXAS HEALTH STEPS PROVIDER INFORMATION Texas Health Steps covers regular medical checkups. These checkups are very important. Your child may look and feel well, but may still have a health problem. With Texas Health Steps, you will know how your child is doing and how to help keep them healthy. During your child's medical checkup, your child's doctor will:

Find health problems early Check to make sure your child is growing right, like other children their age Check your child's teeth and gums Check your child's eye sight and hearing Check to see how well your child is eating Check blood tests when needed Give facts and answer questions you might have about your child's health Give vaccines

Your child may go to any Texas Health Steps Medicaid provider for Texas Health Steps services. Many Cigna-HealthSpring doctors also offer Texas Health Steps services. They are listed in this Provider Directory. You may want to talk to your child's primary care provider first. Also, do not forget to show your Cigna-HealthSpring ID card and the Your Texas Benefits Medicaid ID card to the provider. If you need help picking a Texas Health Steps provider, please call our Member Services Department at 1-877-653-0327, Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711).

iii

ANCILLARY PROVIDER INFORMATION Ancillary providers are providers such as laboratories, diagnostic radiology centers, hearing care providers, and providers of durable medical equipment. To help find a participating ancillary provider, please call your Service Coordinator at 1-877-725-2688 or you can call our Member Services Department at 1-877-653-0327 Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711). HOW TO FIND PROVIDERS IN YOUR AREA To pick a PCP from the Provider Directory, turn to the Primary Care Providers section for a listing of primary care providers in your area. You can also call Member Services at the number below for help picking a primary provider. If you want to change to another PCP, you may do so at any time by calling our Member Services Department at the number listed below. The name and office phone number of your PCP will be printed on your membership card. To pick a specialty care provider, hospital, pharmacy, or other provider, please turn to the specific section in this Provider Directory for a listing of providers in your area. For example, to find hospitals in your area, turn to the Hospitals section of the directory. If you have any questions or need help picking a provider, call our Member Services Department at 1-877-653-0327 Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711). Please note: This directory is current as of August 2019. Some network providers may have been added or removed from the list after this directory was printed. We do not guarantee that each provider is still accepting new Members. To get the most up-to-date information about Cigna-HealthSpring's network providers in your area, you can visit call our Member Services Department at 1-877-653-0327 Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711). To enroll in Cigna-HealthSpring Call 1-800-964-2777 SECTION 2 NETWORK PROVIDERS This directory is arranged to help you find the type of provider you need. Providers are listed in the following sections:

-Primary Care Providers (PCP) -Urgent Care and After Hour Providers -Specialty Care Providers -Hospital Providers -Behavioral Health Providers and Facilities -Long-Term Services and Supports -Pharmacy Providers -Dental Providers -Vision Providers -Ancillary Services

How to use this directory to choose a Primary Care Provider There are two ways to select a primary care provider: -You can choose a particular Primary Care Provider by name or you can choose your Primary Care Provider by location.

If you are looking for a particular Primary Care Provider by name:

1. Go to the Alphabetical Index, which is the last section of the directory.

2. Find the doctor by last name and the page number(s) on which he or she is listed.

3. Go to that page number for information on the Primary Care Provider. If you are looking for a Primary Care

Provider by location:

a)

Go to the Primary Care Provider section.

b)

Find the city and/or zip code.

c)

Select a Provider.

How to use this directory to choose a Specialty Care Provider Specialists in this directory are listed by geographic location, then specialty, followed by name.

How to use this directory to choose other Plan Providers Other plan providers in this directory, such as Behavioral Health Providers and Facilities, are listed by geographic location then the name of the provider.

To enroll in Cigna-HealthSpring Call 1-800-964-2777 iv

DESCRIPTION OF PROVIDER SPECIALITIES Adolescent Medicine (Teenagers) Allergist (Allergies) Ambulatory Medicine (General Non-emergency Care) Cardiology, Cardiovascular (Heart, Blood Vessels) Cardiothoracic Surgery (Operations of the Heart and Chest) Chiropractor (Bones, Joints) Colon/Rectal (Bowels) Dermatology (Skin) Endocrinology (Glands) ENT (Ears, Nose, Throat) Family Practice (General Family Medical Care) Gastroenterology (Stomach, Digestion) Genetics (Inherited Diseases, Birth Defects) Hematology (Blood) Hepatology (Liver) Immunology (Immune System) Infectious Diseases (Viral/Bacterial Infections) Internal Medicine (General Medical Care) Neonatology/Perinatology (Fetus and Newborns) Nephrology (Kidney) Neurology (Brain, Nervous System) Neurosurgery (Operations of the Brain, Spinal Cord) Nuclear Medicine (Testing, i.e. MRI, CAT scan) Nutrition/GI (Eating, Digestion) Obstetrics/Gynecology (Pregnancy, Women's Health) Occupational Medicine (Work-Related Injuries) Oncology (Cancer) Ophthalmology (Eyes) Optometrist (Eyes, Glasses) Oral-Maxillofacial Surgery (Jaw and Mouth) Orthopedics (Bone and Joints) Otolaryngology (Ear, Nose and Throat) Otology (Ears) Pediatrician (Babies, Children) Physical Medicine (Rehabilitation) Plastic Surgery (Corrective Surgery) Podiatry (Feet, Toe Nails) Psychiatry (Mental Illness or Mental Problem) Pulmonology (Lungs, Breathing) Radiology (X-Rays) Renal (Kidney) Reproductive Endocrinology (Reproductive System Diseases) Retrovirology (Viral Diseases, AIDS) Rheumatologists (Joints, Muscles, Tendons) Sports Medicine (Sports Injuries) Surgery (Operations) Thoracic Surgery (Chest Surgery) Urology (Urinary Tract) Vascular Surgery (Operations of the Blood Vessels)

To enroll in Cigna-HealthSpring Call 1- 800-964-2777

v

Tabla de contenido

Secci?n 1

Introducci?n

ii

Informaci?n sobre el m?dico de cabecera

ii

Informaci?n sobre el proveedor de ginecolog?a y obstetricia (OB/GYN)

ii

Informaci?n sobre planificaci?n familiar

iii

Informaci?n sobre las instalaciones y el proveedor de atenci?n del comportamiento

iii

Informaci?n sobre servicios y apoyo de largo plazo

iii

Informaci?n sobre la farmacia

iii

Informaci?n sobre el proveedor de Texas Health Steps

iii

Informaci?n sobre el proveedor auxiliar

iv

C?mo encontrar proveedores en su ?rea

iv

Secci?n 2

Proveedores de la red

v

C?mo elegir a un m?dico de cabecera

v

C?mo elegir a un proveedor especialista

v

Como elegir a otros proveedores del plan

v

Descripci?n de las especialidades del proveedor

vi

Secci?n 3

Lista de proveedores

M?dicos de cabecera (PCP)

1

Proveedores de atenci?n m?dica urgente y despu?s de horas normales de consulta

26

Proveedores especialistas

33

Proveedores en hospitales

71

Centros y proveedores de atenci?n del comportamiento

72

Proveedores de servicios y apoyo de largo plazo

79

Proveedores de farmacia

96

Proveedores dentales

97

Proveedores del cuidado de la vista

98

Proveedores centros de enfermer?a

99

Proveedores de servicios auxiliar

100

Secci?n 4

?ndice de proveedores

111

i MCDTX_13_9881S

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